Nancy Wambura

Manage pre-authorisations, membership validation and cost negotiations for inpatient and outpatient claims, improving cost containment and ensuring compliant benefit allocation. Compile reports, handle fraud detection, and conduct member education and virtual follow-ups to support retention and quality care.

Conducted pre-authorizations and physician liaison to ensure valid, cost-effective admissions and supported a 24-hour helpline, managing fraud detection and client enquiries to maintain quality of care. Negotiated professional fees and conducted client visits for service assurance.

Provided palliative, post-operative, post-stroke rehabilitation and dementia care using nursing process assessments, care planning and multidisciplinary coordination to deliver patient-centered home care and family education.

Delivered primary health care, antenatal/postnatal services, IMCI, PMTCT and medical-surgical nursing, coordinated referrals with community health volunteers, supervised nursing students and supported infection prevention protocols.

Recruited and consented study participants and supported data collection and analysis to facilitate clinical research operations. Maintained participant records and assisted study conduct according to protocol.

Completed a Bachelor of Science in Nursing at the University of Nairobi with training in clinical and community nursing practice.

Grade: A-

Completed Kenya Certificate of Secondary Education with grade A- focusing on secondary school level curriculum.

Grade: 412/500

Completed Kenya Certificate of Primary Education with a score of 412 out of 500.